COVID-19: Impact on Healthcare Professionals and Quality of Health services in Pakistan

COVID-19: Impact on Healthcare Professionals and Quality of Health services in Pakistan

Of all the pandemics the world has ever been hit with, COVID-19 is the most disastrous one, which has brought unprecedented damage to all the nations of the world. The global pandemic has turned the world into a ticking time bomb. After its initial spread from Wuhan, China, the disease rapidly crossed the borders and became a hard challenge for the world. Pakistan is no exception to it. COVID-19 has affected politics, economy, education, and above all the healthcare department. According to the data provided by the government of Pakistan’s official website, the total number of reported cases to date is above thirty-eight thousand. Every day the number of reported cases is about 1581 and 31 deaths are recorded per 24 hours in the country. Being a medical issue there are serious concerns about the threats COVID-19 has posed to the healthcare professionals who are the front line barriers against the disease.

Healthcare Professionals and Hazard of Acquiring Infection

COVID-19 has badly affected the doctors, nurses, paramedics and support staff according to a recent report by the government officials 92 healthcare professionals tested positive for COVID-19 across in two days mounting the total number of infected individuals to 345. In addition to this 1500, healthcare professionals who were exposed to them are quarantined and the test results of many are awaited. To add to the grimness of the situation COVID-19 has claimed the lives of 4 health professionals: ENT specialists prof. M Jawaid, Dr. Abdul Qadeer Soomro, the first martyr Dr. Usama Riaz from GB and a senior nurse at Aziz Bhutti Shaheed Hospital of Gujrat. According to a WHO report on COVID-19 in Pakistan, 132 healthcare providers have been hospitalized, while 152 are isolated at home, and 82 have recovered. Those who contracted the COVID-19 include 181 doctors and 55 nurses while the rest of them are other hospital staff.

Health ministry officials said that there are 93 affected in Punjab: 55 doctors, 16 nurses, and 22 paramedics and support staff. They said that 72 professionals are infected with COVID-19 in khyber Pakhtunkhwa (KP): 35doctors, 6 nurses, and 31 paramedics and support staff. Adding that KP also witnessed the tragic death of one of their senior professors on Saturday due to the virus. They said that 55 professionals have been infected with the novel Coronavirus in Baluchistan: 32 doctors, nurses, 20 paramedics, and support staff, adding that most of the affected area from Bolan medical complex and the Civil Hospital Quetta. They also say that in GB, most of the health professionals infected with the Coronavirus include paramedics and support staff, whose number is 16, while the one doctor who was found infected died during treatment. In Azad Jammu & Kashmir, four health professionals -one doctor and three Paramedical staff member – have been found infected with novel Coronavirus, added ministry officials.

The Dire Shortage of PPE-Another Issue for Healthcare Professionals

Apart from a massive burden placed on the doctors and nurses of treating and attending to COVID-19 patients and suspected cases, yet another problem is the lack of personal protective equipment PPE in Pakistan. Healthcare professionals are neither fully prepared nor sufficiently equipped. PPE shortage struck early last month mainly because the gravity of the situation could not be foreseen. Doctors are angry over the insufficient supply of PPE. The government claims to have provided all the basic facilities to Doctors, nurses, and paramedics but it seems that the available stuff is not enough to stand in the war against this micro creature. Doctors with COVID-19 patients are ascending over a steep curve of death which has its end where we don’t know. 

A BBC report on COVID-19 in Pakistan notes,

“…. Politicians and bureaucrats are often seen wearing N95 masks during meetings and visits…. Health professionals are facing a dire shortage of these masks and PPE.”

BBC News

The near absence of the protective gear stirred unrest among the already strained community of doctors and other healthcare professionals with doctors resorting to brief protests and strikes.

The tension further escalated when police intervened and tried to disperse the crowd of doctors from Quetta Civil Hospital. They were beaten with sticks and fists. More than two dozen healthcare professionals were arrested and later released. The strike has been called off but the countrywide protest and demand of PPE continue which is the due right of the health professionals.

The Psychological Impact of COVID-19 on Healthcare Professionals

According to a recent study conducted in Greece, during the outbreak of COVID 19, clinicians in Greece have confronted with mounting challenges that have not been faced before. Decisions have to be made fast ranging from efficiently triaging and isolating patients to deciding whether to shut down the department in case patient or staff tests positive. Healthcare staff fears the bringing of the virus to their families and children. They are under extreme psychological stress when they have to deal with an unwilling patient. A similar study in China reveals that the high incidence of stress and anxiety disorders prevails in the health professionals after the COVID 19 outbreak. Likewise, Pakistani doctors and nurses feel nervous about the situation because of the naivety and the fragile condition of the patients. In addition, the media scrutiny and the limited resources add to the misery of the situation.

Quality of Health Services Provided to the Patients in Pakistan

Since the commencement of the outbreak, the government has started establishing the Quarantine centers all over Pakistan. Up-till-now Govt. has established thousands of Quarantine center in almost 63 cities of Pakistan with a maximum number of beds available in the centers of Taftan which can accommodate almost 4950 patients, followed by the Faisalabad, Bahawalpur, and Multan each having the facility of 2852,  2000  and 1836 beds respectively with a total number of beds 23557. (Pakistan, List of Province-wise COVID-19 Quarantine Facilities Pakistan, 2020).  Moreover, many of the three-star hotels and hostels of medical colleges are being converted to Quarantine centers.

General Muhammad Afzal told in a press conference,

  “We have also booked roughly 1,795 three-star and four-star hotels, with a collective capacity of 42,000 single-bed rooms, to use them as quarantine centers. We have also locked six hotels with five-star facilities if needed.”

voa news

All the hospitals require special isolation wards to treat COVID-19 patients. The COVID patients should not have entry to OPDs of hospitals as they can affect other people there. Therefore, 215 Isolation wards are opened in almost 21 cities of Pakistan having 2942 beds.  According to Gen. Afzal, the number has increased to 162000 beds in all the centers. The government is increasing the number of Intensive care units (ICU) in different hospitals.  “The number of intensive care units in hospitals around Pakistan has risen from 700 just a couple of weeks ago to about 20,000”, Afzal said.

Pakistan has faced a shortage of testing facility at the start of the pandemic. There was a daily capacity of 17214 tests until April 2020 but now the capacity has increased to almost 25000 per day. There lies a mass hysteria in the Doctors community as this pandemic has proved to be a suicide mission for them. A couple of doctors have denied treating COVID patients due to its high transfer rate. There is a shortage of Healthcare workers despite enough availability of medical equipment. Govt. has recently recruited almost 1000 Medical officers through PPSC. The dire need of the time is to make an effective policy for the safety and protection of the health professionals and arrangements for the patients on an urgent basis.

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Aamat ul Fatima
Muhammad Usama
Kumail Ijaz

Post by: Aamat ul Fatima, Muhammad Usama, Kumail Ijaz

All contributing authors are third year M.B.B.S. students at King Edward Medical University, Lahore. Pakistan.

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